Software Technology, Inc.

Software Technology, Inc. is looking for an IT Healthcare Consultant with extensive experience in healthcare insurance, medical coding, and collaboration with IT developers. The ideal candidate will have at least 5 years in medical review and appeals, along with strong clinical healthcare knowledge. The role requires a BSN or ADN degree and an active RN License in South Carolina. Preferred skills include policy remediation and experience with claims processing systems. #J-18808-Ljbffr

IT - SCDHHS - IT Healthcare Consultant - Business Analyst - Advanced Location: Columbia, SC (20% onsite) Required Skills 5+ years healthcare insurance (medical review / appeals / program integrity) 5+ years working with IT developers in payer environment 5+ years medical coding (payer side) 3+ years clinical healthcare experience 5+ years ICD-10 / CPT / HCPCS knowledge Strong anatomy, physiology, pharmacology, medical terminology Additional Strong written & verbal English communication Preferred Policy remediation experience Claims processing systems MS Office Optum Encoder / coding software Education BSN or ADN Certifications Active RN License – South Carolina CPC or CCS certification ICD-10 certified or within 1 year. #J-18808-Ljbffr